Elevated Serum Levels of Zonulin Family Peptides in Anticitrullinated Protein Antibody–Positive At-Risk Individuals Without Arthritis

Hemgren, C; Martinsson, K; Rooney, C; Wetterö, J; Mankia, K; Emery, P; Kastbom, A

doi:10.3899/jrheum.2023-0160

Rheumatoid arthritis

Elevated Serum Levels of Zonulin Family Peptides in Anticitrullinated Protein Antibody–Positive At-Risk Individuals Without Arthritis

J RheumatolPublished 1 Dec 2023Prospective cohort study

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Authors' conclusion

Serum ZFP levels are elevated in ACPA-positive at-risk patients when compared to both healthy blood donors and symptomatic ACPA-negative controls.

Study context

Population: Subjects with musculoskeletal symptoms and anticitrullinated protein antibodies (ACPA) but without clinical arthritis at baseline, Sweden and UKtwo cohorts
Participants: 82 / 100 / 307 / 100

Exposure: ACPA-positive at-risk individuals vs healthy blood donors (Sweden) and vs ACPA-negative symptomatic controls (UK)
Swedish at-riskn = 82
Healthy blood donorsn = 100reference
UK at-riskn = 307
ACPA-negative symptomatic controlsn = 100reference
Outcome: Serum zonulin family peptide (zonulin family peptides (ZFP)) levels at baseline and their association with arthritis development
Follow-up: Baseline

Methodological detailstwo independent prospective observational cohorts, age-matched healthy controls (Swedish cohort)

Two independent prospective observational cohorts
Age-matched healthy controls (Swedish cohort)

Main finding

As reported in the abstract

Serum ZFP levels

Swedish at-risk41.4mean · ng/mL

Healthy blood donors33.6mean · ng/mL

UK at-risk69.7mean · ng/mL

ACPA-negative symptomatic controls36.0mean · ng/mL

Swedish at-risk vs Healthy blood donors: P < 0.001 · UK at-risk vs ACPA-negative symptomatic controls: P < 0.001

Observational data: associations, not effects.

Further findings

Outcome	← Lower ←→ Higher →	HR per ng/mL ZFP increase (95% CI)	P value
Arthritis development per ng/mL ZFP increase (Cox regression)Swedish at-risk	0.512	1.04 (1.01–1.07)	P = 0.02
Arthritis development per ng/mL ZFP increase (Cox regression)UK at-risk	0.512	1.00 (1.00–1.01)	P = 0.30
	0.512Hazard ratio per ng/mL ZFP increase (log scale)

Original publication

Elevated Serum Levels of Zonulin Family Peptides in Anticitrullinated Protein Antibody–Positive At-Risk Individuals Without Arthritis. J Rheumatol. Published 1 December 2023. doi:10.3899/jrheum.2023-0160

Read the original article ↗

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